RANDALL KENNETH SHIVELY PH.D, LICDC
NPI 1235608084
Psychologist - Intellectual and Developmental Disabilities in Columbus, OH
NPI Status: Active since November 21, 2018
Contact Information
2100 STELLA CT
COLUMBUS, OH
ZIP 43215
Phone: (614) 252-8402
Fax: (614) 252-5326
- Individual
- Male
- Psychologist
- Intellectual and Developmental Disabilit...
- Accepts Insurance
- PECOS Enrolled
About RANDALL SHIVELY
This page provides the complete NPI Profile along with additional information for Randall Shively, a provider established in Columbus, Ohio with a medical specialization in Psychologist, focusing in intellectual and developmental disabilities . The healthcare provider is registered in the NPI registry with number 1235608084 assigned on November 2018. The practitioner's primary taxonomy code is 103TM1800X with license number 4374 (OH). The provider is registered as an individual and his NPI record was last updated 2 years ago.
- NPI
- 1235608084
- Provider Name
- RANDALL KENNETH SHIVELY PH.D, LICDC
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 2100 STELLA CT COLUMBUS, OH 43215
- Location Phone
- (614) 252-8402
- Location Fax
- (614) 252-5326
- Mailing Address
- 2100 STELLA CT COLUMBUS, OH 43215
- Mailing Phone
- (614) 252-8402
- Mailing Fax
- (614) 252-5326
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 11-21-2018
- Last Update Date
- 04-25-2023
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Psychologist Intellectual and Developmental Disabilities
- Taxonomy Code
- 103TM1800X
- Type
- Behavioral Health & Social Service Providers
- License No.
- 4374
- License State
- OH
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 101YA0400X | Behavioral Health & Social Service Providers | Counselor | 975850 (OH) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Bronze 10 - HMO
- Bronze 8 - HMO
- Bronze 9 - HMO
- Gold 1 - HMO
- Gold 1 with Adult Vision Services - HMO
- Gold 8 - HMO
- Silver 1 - HMO
- Silver 1 with Adult Vision Services - HMO
- Silver 12 with first 4 free PCP or MH visits - HMO
- Silver 8 - HMO
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
- UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - HMO
- UHC Bronze Standard (No Referrals) - HMO
- UHC Bronze Standard+ (Dental + Vision, No Referrals) - HMO
- UHC Bronze Value ($5 Tier 2 Rx, No Referrals) - HMO
- UHC Bronze Value+ ($5 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
- UHC Gold Advantage ($3 Tier 2 Rx, No Referrals) - HMO
- UHC Gold Advantage+ ($3 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
- UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
- UHC Gold Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
- UHC Gold Standard (No Referrals) - HMO
- UHC Gold Standard+ (Dental + Vision, No Referrals) - HMO
- UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
- UHC Silver Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
- UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
- UHC Silver Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - HMO
- UHC Silver Standard (No Referrals) - HMO
- UHC Silver Standard+ (Dental + Vision, No Referrals) - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Randall Shively is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Durable Medical Equipment (DME).
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: No
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): No
Eligible to Order or Refer Power Mobility Devices: No
Reviews for RANDALL KENNETH SHIVELY PH.D, LICDC
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 2 | 3 | 5 | 6 | 0 | 8 | 0 | 8 | 4 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 2 | 6 | 5 | 12 | 0 | 16 | 0 | 16 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 2 + 6 + 5 + 1 + 2 + 0 + 1 + 6 + 0 + 1 + 6 + 24 = 56 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 56 = 4 | 4 | ||||||||
The NPI number 1235608084 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1295943702 | MISTI SELLERS PSYD Individual | Student in an Organized Health Care Education/Training Program | 2100 STELLA CT COLUMBUS, OH 43215 (614) 252-8402 |
| 1487128088 | RAVON ASHLEY JOHNSON Individual | Counselor (Addiction (Substance Use Disorder)) | 2100 STELLA CT COLUMBUS, OH 43215 (614) 252-8402 |
| 1124676655 | NELLIE M REMSON Individual | Counselor (Addiction (Substance Use Disorder)) | 2100 STELLA CT COLUMBUS, OH 43215 (515) 867-4177 |
| 1326660010 | NICOLE MARIE JOHNSON Individual | Behavior Analyst | 2100 STELLA CT COLUMBUS, OH 43215 (614) 949-3223 |
| 1033791660 | TINA HOWARD Individual | Community Health Worker | 2100 STELLA CT COLUMBUS, OH 43215 (614) 252-8402 |
| 1780266999 | KOCHIYA MCDADE QMHSIII Individual | Case Manager/Care Coordinator | 2100 STELLA CT COLUMBUS, OH 43215 (614) 252-8402 |
| 1033786769 | DEBORAH FINNEGAN Individual | Counselor | 2100 STELLA CT COLUMBUS, OH 43215 (614) 252-8402 |
| 1437720620 | MARKEISHA WRIGHT QMHS Individual | Community Health Worker | 2100 STELLA CT COLUMBUS, OH 43215 (614) 252-8402 |
| 1437721149 | LYNN GREENFEDER Individual | Behavior Technician | 2100 STELLA CT COLUMBUS, OH 43215 (614) 252-8402 |
| 1144892688 | SHELLY L THIGPEN QMHSIII Individual | Counselor | 2100 STELLA CT COLUMBUS, OH 43215 (614) 252-8402 |
| 1275106940 | RACHEL MULLENS PARAPROFESSIONAL Individual | Behavior Technician | 2100 STELLA CT COLUMBUS, OH 43215 (614) 252-8402 |
| 1346917879 | MICHAELLE MAY QMHS III Individual | Peer Specialist | 2100 STELLA CT COLUMBUS, OH 43215 (614) 252-8402 |
| 1588314702 | ALISON EVANS CDCA Individual | Counselor | 2100 STELLA CT COLUMBUS, OH 43215 (614) 252-8402 |
| 1962113126 | MONIQUE R SMITH CDCA.180172 Individual | Counselor (Addiction (Substance Use Disorder)) | 2100 STELLA CT COLUMBUS, OH 43215 (614) 252-8402 |
| 1114650579 | OSSIE MAE DORNOO CNP Individual | Community/Behavioral Health | 2100 STELLA CT COLUMBUS, OH 43215 (614) 252-8402 |
| 1386993350 | ALVIS INC Organization | Community/Behavioral Health | 2100 STELLA CT COLUMBUS, OH 43215 (614) 252-8402 |
| 1578266409 | JOEY GOODMAN PARA PROFESSIONAL Individual | Community Health Worker | 2100 STELLA CT COLUMBUS, OH 43215 (614) 502-7812 |
| 1366132300 | DOMINIQUE THARP Individual | Community Health Worker | 2100 STELLA CT COLUMBUS, OH 43215 (614) 502-7812 |
| 1811568926 | CHRISTINA ROYER LCDC III & CDCA Individual | Counselor (Addiction (Substance Use Disorder)) | 2100 STELLA CT ATTN: LENORA ISAACS COLUMBUS, OH 43215 (614) 252-8402 |
| 1184496960 | SAMANTHA JO BRAY CDCA Individual | Counselor (Addiction (Substance Use Disorder)) | 2100 STELLA CT COLUMBUS, OH 43215 (614) 252-8402 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1235608084, enumerated in the NPI registry as an "individual" on November 21, 2018
The provider is located at 2100 Stella Ct Columbus, Oh 43215 and the phone number is (614) 252-8402
The provider's speciality is Psychologist with taxonomy code 103TM1800X with a focus in Intellectual and Developmental Disabilities
The provider might be accepting Accepts: Molina Healthcare and UnitedHealthcare. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Durable Medical Equipment (DME).
This NPI record was last updated on November 21, 2018. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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